Waiting, watching, holding their breath, as NHS Scotland’s A&E performance consolidates, they spot a bit of ‘worsening!’
In week ending 16 April 2023, down from 64.9% seen within 4 hours in the previous week to…..wait for it…..63.4%…a whole 1.5%!!!
But, Dad, that’s not significant. You get weekly variations like these below, all the time. Monthly figures would be better.
64.9% seen in 4 hours in week-ending 21 August 2022 and the very same on 9 April 2023 and way up on 55.9% in January 2023.
So, what’s the trend?
Anyhow back to the monthly figures.
In March 2023, it was 64.5%.
How does that compare?
In England it was 56.8%.
13.55% better in Scotland
And, and, that’s only half the story. How quickly do Scottish ambulances get you there?
From the House of Commons Library briefing on 13 March 2023:
Ambulance response times have risen, with the average response to a Category 2 call at over 1 hour
30 minutes in December 2022.https://researchbriefings.files.parliament.uk/documents/CBP-7281/CBP-7281.pdf
From the Scottish Ambulance Service on 19 December 2022:
Red incidents [same as cat 2 in England] – Median: 10 minutes 19 seconds; 90th Percentile: 24 minutes 33 seconds.https://www.scottishambulance.com/publications/previous-unscheduled-care-operational-statistics/
An average of over 90 minutes to get an ambulance for a Category 2 call in England compared with a median of 10 mins and 19 secs and 90% within 24 mins and 33 seconds, for the equivalent in Scotland.
Definitions:
Scotland:
Purple: Our most critically ill patients. This is where a patient is identified as having a 10% or more chance of having a cardiac arrest. The actual cardiac arrest rate across this category is approximately 53%.
Red: Our next most serious category where a patient is identified as having a likelihood of cardiac arrest between 1% and 9.9%, or having a need for resuscitation interventions such as airway management above 2%. Currently the cardiac arrest rate in this category is approximately 1.5%.
England:
Category 1: An immediate response to a life-threatening condition, such as cardiac or respiratory arrest. The average response time should be under 7 minutes and 90% of ambulances should arrive within 15 minutes.
Category 2: A serious condition, such as stroke or chest pain, which may require rapid assessment and/or urgent transport. The average response time should be under 18 minutes and 90% of ambulances should arrive
within 40 minutes.
Sources:
Talking-up Scotland 
And note in Tom’s headline the seamless change of ‘under fire’ from NS to HY…
As has often been highlighted and exampled here, Scotland is the only segment of the NHS where the media contrive to attach ‘blame’ to a named politician in reporting, it happens nowhere else.
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And slightly OT John, but this latest for England is quite astonishing https://www.taxresearch.org.uk/Blog/2023/04/26/the-nhs-in-england-is-not-being-allowed-to-recruit-new-staff/
“NHS England has told many trusts and systems they are not allowed to increase their staffing establishment in the next 12 months.”
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This may come as a disappointment to those in Scotland who vote Labour at Holyrood elections. Their favoured party – whose health spokesperson endlessly berates the Scottish Government’s track record on NHS Scotland’s A&E performance – DOES NOT have the solution to A&E challenges. Well if it does, it’s NHS policy guru, Ms Baillie can’t be sharing it with party colleagues in government in Wales.
This is from the Royal College of Emergency Medicine (RCEM) only last week in response to the latest Emergency Department performance figures for March 2023 for Wales (with my emphasis):
Dr Suresh Pillai, Vice President of the Royal College of Emergency Medicine Wales stated: “THE DATA ARE STARK. Patients continue to face long-waits. Hardworking staff are doing their best to mitigate the harm to patients that we know is associated with these delays to care.
‘Recently in England, 12-hour data measured from the time of arrival was made publicly available in a step towards more transparent and meaningful metrics that better reflects the patient’s journey and show the true scale of long waits. IN WALES, MANY PATIENTS ARE STILL HIDDEN FROM THE DATA, masked by clinical and operational exclusions, classified as breach exemptions.
“The Health Minister and THE WELSH GOVERNMENT MUST FOLLOW THE EXAMPLE OF NHS ENGLAND to ENSURE DATA ARE MEANINGFUL AND TRANSPARENT and no patient is excluded. We can only tackle the crisis at its root and eliminate the delays to care and overcrowding when we can see the full picture with no exceptions.’
Adding this summary: ‘The delays and dilution to care are driven by high bed occupancy, a low bed base, and an inability to discharge patients in a timely way due to unresponsive social care.’
And: ‘IN WALES, THERE IS A SEVERE RETENTION AND RECRUITMENT CRISIS in Emergency Medicine. We must do all we can to retain existing staff and keep them delivering for patients, while simultaneously recruiting staff into Emergency Medicine. A FAILURE TO EITHER RECRUIT OR RETAIN STAFF IS A FAILURE TO OUR PATIENTS. IT IS ESSENTIAL THAT WORKFORCE IS A PRIORITY OF THIS GOVERNMENT.”
Given the nature, the tone of Labour in Scotland’s opposition to the Scottish Government over A&E performances, how is it even possible that ALL the above could be happening under a Labour government’s watch? How could Ms Baillie and her MSP comrades in Holyrood fail to pass on their well thought through, well evidenced oven-ready solutions they have developed for A&E in NHS Scotland?
The RCEM statement also summarises the March 2023 performance statistics for major A&E departments in NHS Wales:
‘Overall, 59.9% of patients in major Emergency Departments were admitted, transferred, or discharged within four-ours from arrival
This is the first drop in four-hour performance since December 2022.’
‘2% of major Emergency Department attendances waited more than 8 hours (15,269 patients). THIS IS 25.1% MORE THAN THE PREVIOUS MONTH. This is equal to nearly one in four patients.’
‘1% of major Emergency Department attendances waited more than 12-hours (9,924 patients). THIS IS 24.4% MORE THAN THE PREVIOUS MONTH. This is the lowest figure since July 2021. This is equal to nearly one in seven patients.’
Source: https://rcem.ac.uk/emergency-department-12-hour-length-of-stay-data-must-be-meaningful-and-transparent/
And this is what NHS A&E performance looks like under a Labour Government! Labour in Scotland really needs to demonstrate solidarity with Wales as a matter of urgency and share the ‘fix’ that Ms Baillie demands the Scottish Government implements.
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